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Potential for Healthcare Kiosks in Improving Care Delivery

Kiosks are all the rage in retail and service industries, but can healthcare kiosks make a difference for providers and patients?

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Kiosks are all the rage in retail and service industries, but can healthcare kiosks make a difference for providers and patients?

The simple answer is yes, if done right. They give healthcare providers a chance to collect data and automate tasks that gobble up valuable time in the doctor’s office, clinic, or hospital. And they can give the consumer quick access to a healthcare provider or service in places where access is limited.

Merriam-Webster defines the kiosk as “a small structure with one or more open sides that is used to vend merchandise (as newspapers) or services (as film developing)” or “a small stand-alone device providing information and services on a computer screen.” It’s derived from the Turkish kosk, which itself comes from the Persian kushk, meaning “portico.”

A brief history of healthcare kiosks

The first known kiosk was a wayfinding station called the Plato Hotline, developed in 1977 by a pre-med student at the University of Illinois, according to Bradley Cooper of KioskMarketplace.com. The first retail kiosk — the Florsheim Express Shop — appeared in 1984. They didn’t start showing up in healthcare, however, until the early 2000s.

In healthcare, kiosks come in many form factors, ranging from the fully enclosed chamber made famous by the now-bankrupt HealthSpot (and still championed by a number of telehealth vendors) to smaller, semi-enclosed booths common in pharmacies and all the way down to something resembling an office cubicle.

Outside the healthcare setting, the kiosk’s main function is to replicate the visit to a doctor’s office, offering quick consults in a public setting such as a community center, jail, school, retail store, mall, office building or airport. Inside the pharmacy, hospital or clinic, they most often act as registration stations or patient education terminals. They can even be used as triage stations in an ED.

In 2015, the healthcare consultancy IHS Technology predicted that healthcare kiosks will increase from roughly 10,000 to more than 36,000 by 2020, with a lot of that growth driven by large businesses and manufacturers seeking on-site healthcare services. According to a 2014 study by Mercer, almost 30 percent of companies with more than 5,000 employees have kiosks.

"Large employer group customers see kiosks as a key part of their strategy to improve access to healthcare, manage costs and enhance productivity," says John Jesser, Anthem Vice President and LiveHealth Online General Manager, whose telehealth service is integrated in American Well kiosks in more than 20 locations. "With a kiosk, depending on their health plan benefits, employees can see a doctor covered under their health plan without ever leaving the worksite, for a fraction of the cost involved in a worksite clinic."

They reach “the invisible” – consumers who aren’t motivated or sick enough to visit a hospital or clinic;

They can engage the consumer by “simple actions,” such as connecting via video to a provider or pointing out nearby products or services;

They offer providers a new revenue stream, particularly through advertising;

They offer a means of targeted, personalized marketing; and

They offer early innovators a chance to get in on the ground floor of a marketing phenomenon.

With kiosks, bigger does not always mean better — a lesson learned the hard way by HealthSpot, which emerged in 2012 with a high-tech, eight-by-five-foot, wholly enclosed room and went bankrupt in January 2016. The company touted partnerships with the likes of the Mayo Clinic, the Cleveland Clinic, Kaiser Permanente and Rite-Aid, but was unable to generate a sustainable business plan for its 190 kiosks.

“It was not a failure of concept,” Matt Stanton, Business Director for Telemedicine at the Cleveland Clinic, said following the company’s collapse. He said the kiosks met with initial success, but the health system gradually shifted its attention and resources to smaller, less complicated and more nimble projects, like mHealth apps and platforms.

In short, the kiosk looked great and did a good job giving the consumer a virtual checkup, but it was too much — consider the popular analogy of using a sledgehammer to pound in a nail.

"Large employer group customers see kiosks as a key part of their strategy to improve access to healthcare, manage costs and enhance productivity."

That type of kiosk is also running the risk of being outdated, much like the telephone booth or the photo lab. Where entrepreneurs once dreamed of dropping them into remote African villages, remote health workers are now doing the same job with a laptop or tablet, a smartphone and a digital stethoscope and thermometer. Once praised for their mobility, kiosks aren’t mobile enough.

Putting healthcare kiosks to work

So where do they work? Here are a few examples:

In a busy emergency department, small kiosks can enable staff to gather patient data — symptoms, personal information, payment options — before dispatching a nurse or doctor. In some cases, the kiosk can connect the patient to a healthcare provider in another location, potentially screening out non-emergency cases that clog up an ER, keep more urgent cases waiting and waste clinicians’ time. On the flip side, that type of access would certainly appeal to ER visitors who doesn’t want to wait a long time to have a simple health issue addressed.

“This is going to be cheaper and more efficient for ambulatory patients who want to just go someplace and get checked out.”

In a doctor’s office or clinic, kiosks enable patients to check in and update their health records, freeing up office staff and giving the doctor or nurse a more complete record of the visit before he or she even sees the patient. This makes the actual doctor-patient encounter more meaningful for both sides, potentially improving the clinical outcome as well as patient satisfaction. A patient can also use a kiosk to arrange payment or schedule future appointments.

In remote or public locations, a stripped-down version of the kiosk gives consumers quick access to a remote healthcare provider for simple health issues. Some companies see this as a cost-effective alternative to the retail clinic or community health station.

Some mHealth developers see a market for kiosks in developing nations. DaVincian Healthcare, based in Austin, is working with Indian telemedicine provider HelloDoctor24x7 to launch some 4,000 kiosks in the poorest parts of that nation. The Dubai Health Authority, meanwhile, is touting what it calls “smart healthcare kiosks” in the United Arab Emirates, in a region where privacy — especially for women — often affects healthcare access.

Aside from the use around the globe, areas of growth within the US will likely focus on retail locations, businesses and in specialty uses, such as marijuana and medication dispensing.

In Miami, Pharmabox has launched a kiosk that carries close to 150 over-the-counter products, ranging from cold and allergy medications to personal health items. In states where marijuana is legal, meanwhile, a company called Janefour20 is marketing a kiosk that registers every user, logs all transactions, ensures all legal and financial concerns are met, and dispenses the product.